Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. I am taking this debate on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, who is on Government business elsewhere.

While there will always be a need for long-term residential care, older people have consistently said they want to stay in their homes and communities for as long as possible, and the Government is committed to facilitating this. The review of the nursing homes support scheme, to be published next week, will include consideration of the need for continued development of home and community-based services alongside continued support for residential care. The HSE already provides significant levels of home supports. The executive will expend approximately €330 million this year on home-based supports. The HSE's national service plan for 2015 provides a target of 10.3 million hours of home help with a budget of approximately €185 million. This matches the 2014 budget for this area.

In addition to the mainstream home help service, which provides assistance with personal care, such as washing, dressing and essential domestic chores, the home care package scheme provides assistance for those with more complex care needs. As well as helping with the essential tasks of daily living, a home care package may include community nursing, therapy services, aids and appliances and respite care. The 2015 service plan provides for €135 million for home care packages to support 13,600 people at any one time. This represents an increase on 2014, when €130 million was provided to support 13,200 clients. As part of a measure introduced in 2014, a further €10 million has been made available to provide intensive home care packages for up to 190 people at any given time. These people would otherwise have to remain in acute hospital or long-stay residential care settings. This initiative could help to keep up to 250 people with complex care needs at home for longer.

The HSE is progressing a range of measures to improve home care provision overall, standardise services nationally and promote quality and safety. Providers are monitored through service level agreements with the HSE. These are supervised through regular local operational meetings and review of care plans.

The HSE is currently undertaking a full review of home care services with a view to improving services generally. This includes the preparation of national quality guidelines which will apply to all home support services, including those procured by the HSE from external providers.

Notwithstanding the significant improvements in the overall economic position that we have seen in recent times, significant pressures continue to apply across the health service and finding the resources to develop home care services in the way I would like continues to be a real challenge. However, there is no doubt that supports delivered in the home and in other community settings will play an ever-increasing part in supporting our older people, and I will ensure home-based services are given adequate priority when it comes to allocating available resources across services for next year.

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